Shoulder Orthopaedic Test: Scapular Assistance Test

The Scapular Assistance Test is a physical examination maneuver used to assess scapular motion and identify scapular dyskinesis, which is an abnormal scapular movement pattern. The test involves using manual assistance to improve scapular motion and determining whether this improves symptoms or range of motion.

Here are the steps to perform the Scapular Assistance Test:

1. Ask the patient to assume a standing or sitting position with their arms by their sides.
2. Observe the patient's scapular position and motion during arm elevation.
3. With one hand, provide manual assistance to the scapula by applying pressure in a superior and lateral direction.
4. Instruct the patient to perform arm elevation again.
5. Observe whether the scapular position and motion have improved compared to the initial observation.
6. Ask the patient if their symptoms, such as pain or discomfort, have improved during the assisted arm elevation.
7. Repeat the test on the other side.
8. Document the result of the test in the patient's medical record.

A positive Scapular Assistance Test result is indicated by improved scapular motion and/or a reduction in symptoms during assisted arm elevation compared to the initial observation. This finding may suggest scapular dyskinesis as a contributing factor to the patient's symptoms.

References:

1. Kibler WB, Sciascia AD, Uhl TL, Tambay N, Cunningham T. Electromyographic analysis of specific exercises for scapular control in early phases of shoulder rehabilitation. Am J Sports Med. 2008;36(9):1789-1798.
2. Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther. 2000;80(3):276-291.
3. Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology Part III: The SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthroscopy. 2003;19(6):641-661.